Victorian Premier Daniel Andrews will likely need a reasonably long period to recover after his fall this week and is being advised to take his time to make a full recovery, two orthopaedic surgeons have told the ABC.
Mr Andrews broke some ribs and fractured his T7 vertebra when he slipped and fell on wet stairs at a holiday house on the Mornington Peninsula on Tuesday.
In the most recent update, Dr Steve McGloughlin from The Alfred hospital said Mr Andrews was comfortable and in a stable condition and that his pain is “well controlled.”
He described the injuries as “serious” and said a “multidisciplinary team” involving intensive care, trauma and orthopaedic specialists had developed a treatment plan.
We spoke to two orthopaedic surgeons, Mr John Cunningham and Dr Michael Gillespie, for their opinions on the Premier’s treatment options and recovery.
Pain will be the main issue in the coming days
Mr Cunningham doesn’t have any inside information about the Premier’s condition, but says he is likely going to need pain relief for a while.
“Unlike a broken ankle, which you can put in plaster and rest it by using crutches — you can never really rest your spine or your ribs,” he said.
Broken ribs are painful and when the damaged vertebra is in the same area, even more so.
“He’ll be able to be on the phone and using his computer and stuff pretty quickly,” Mr Cunningham said.
“But while he’s taking analgesics and his mind is occupied by pain, I think everyone would prefer he wasn’t in charge of the state.”
Dr Gillespie, who is the president of the Australian Orthopaedic Association, said Mr Andrews had a “fall of some consequence” and was in good hands with the experts at The Alfred.
“I’m sure they are exercising —as it is customary to say —an abundance of caution,” he said.
“If you’re doped to the gills on strong painkillers, that’s something less than your sparkling best.”
Surgery or a brace — either way, it’s painful
The Premier’s doctors at The Alfred said there are no immediate plans to do surgery.
But if they did operate, they may use screws and rods to stabilise the damaged vertebra or other devices to restore the spine to the proper shape.
If he’s not having surgery, he may have to wear a brace instead.
“They can be cumbersome and the patient has to be compliant — which means he’s going to be given some rules he has to follow,” Mr Cunningham said.
Dr Gillespie said every individual case was different and a lot of work went into deciding whether or not to operate.
For example, he said doctors would assess what parts of the T7 vertebra were broken, work out if the damaged area was stable and determine if there was the potential for the compression of the spinal cord.
“They would be looking to see how he progresses clinically and they’d probably be repeating the imaging to make sure nothing has shifted or that any deformity that is there isn’t progressive,” Dr Gillespie said.
How long the recovery will be is anyone’s guess
At the peak of the COVID crisis in 2020, Mr Andrews conducted 120 consecutive press conferences — often lasting well over an hour.
Dr Gillespie said it would probably be some time before he was well enough to do that again.
“Whether that’s weeks or many months, it’s hard to say without knowing the specifics of the injury,” he said.
“I would be having a very cautious approach.”
Mr Cunningham said it would be a long and slow recovery but he’d expect Mr Andrews to be back to normal within six to 12 months.
“If I was his treating doctor, I’d be telling him to take his mind off work and have a good break from work,” he said.
In the meantime, he’ll need some “tender loving care from his family” and lots of rest.
“I think everyone would agree he probably deserves that,” Mr Cunningham said.
Dr Gillespie’s advice to the Premier?
“Listen to your body and accept that all of these injuries take more out of you than you think,” he said.